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Influence of thoracolumbar kyphosis on postoperative spinal alignment in patients with Lenke type 5C adolescent idiopathic scoliosis

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Abstract

Purpose

This study aimed to examine the changes in thoracolumbar kyphosis (TLK) following correction surgery in patients with Lenke type 5C adolescent idiopathic scoliosis (AIS) and to evaluate its influence on postoperative spinal alignment and clinical outcomes.

Methods

Sixty-six patients with Lenke type 5C AIS were included and followed up for a minimum of 5 years after surgery. First, the patients were divided into two groups according to the preoperative TLK angle (Study 1; Kyphosis and Lordosis group). The patients were further classified into two groups according to the presence or absence of postoperative changes in TLK (Study 2; Changed and Maintained groups). Finally, the outcome variables were compared between these groups and analyzed for spinal alignment and clinical outcomes.

Results

In Study 1, patients demonstrated a significant kyphotic change in the Lordosis group and a significant lordotic change in the Kyphosis group postoperatively. No statistically significant differences were found between the two groups when comparing the pre- and postoperative coronal and sagittal alignment. In Study 2, there were no statistically significant differences between the Changed and the Maintained groups in each spinal alignment pre- and postoperatively. Each domain of the Scoliosis Research Society 22-item questionnaire remained unchanged at 5 years postoperation.

Conclusion

In many patients with Lenke type 5C AIS, TLK changed significantly and approached 0° after surgery. However, the magnitude of the preoperative TLK and the presence or absence of improvement did not affect postoperative spinal alignment. Furthermore, the patients had satisfactory clinical outcomes irrespective of TLK modification.

Level of evidence

III.

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Data availability

The data is available with request from the authors.

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Acknowledgements

The authors would like to thank Editage (https://www.editage.jp/) for the English language review.

Funding

We have received no funding for this study.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, Japan

    Toshiki Okubo, Satoshi Suzuki, Masahiro Ozaki, Yohei Takahashi, Osahiko Tsuji, Narihito Nagoshi, Morio Matsumoto, Masaya Nakamura & Kota Watanabe

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  1. Toshiki Okubo
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  2. Satoshi Suzuki
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  3. Masahiro Ozaki
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Contributions

TO: substantial contributions to the conception and design of the work; or the acquisition, analysis, or interpretation of data for the work; drafting of the manuscript; final approval of the version to be published; agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. SS, MO, YT, OT, NN: substantial contributions to the conception and design of the work; and the acquisition, analysis, and interpretation of data for the work; revising it critically for important intellectual content; final approval of the version to be published; agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. MM, MN: substantial contributions to the acquisition, analysis, and interpretation of data for the work; revising it critically for important intellectual content; final approval of the version to be published; agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. KW: substantial contributions to the conception or design of the work; and the acquisition, analysis, and interpretation of data for the work; drafting of the manuscript and revising it critically for important intellectual content; final approval of the version to be published; agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Corresponding author

Correspondence to Kota Watanabe.

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Conflict of interest

There are no conflicts of interest to declare.

Ethical approval

This study was approved by the Committee on Ethics and Institutional Review Board of Keio University School of Medicine. The procedures used in the present study adhere to the tenets of the Declaration of Helsinki.

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All participants provided informed consent before inclusion in the study.

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Okubo, T., Suzuki, S., Ozaki, M. et al. Influence of thoracolumbar kyphosis on postoperative spinal alignment in patients with Lenke type 5C adolescent idiopathic scoliosis. Spine Deform (2023). https://doi.org/10.1007/s43390-023-00782-y

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